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Projected increase in obesity and non-alcoholic steatohepatitis-related liver transplantation waitlist additions in the United States
Hepatology ( IF 13.5 ) Pub Date : 2018-05-14 , DOI: 10.1002/hep.29473
Neehar D Parikh 1 , Wesley J Marrero 2 , Jingyuan Wang 2 , Justin Steuer 1 , Elliot B Tapper 1 , Monica Konerman 1 , Amit G Singal 3 , David W Hutton 2, 4 , Eunshin Byon 2 , Mariel S Lavieri 2
Affiliation  

Nonalcoholic steatohepatitis (NASH) cirrhosis is the fastest growing indication for liver transplantation (LT) in the United States. We aimed to determine the temporal trend behind the rise in obesity and NASH‐related additions to the LT waitlist in the United States and make projections for future NASH burden on the LT waitlist. We used data from the Organ Procurement and Transplantation Network database from 2000 to 2014 to obtain the number of NASH‐related LT waitlist additions. The obese population in the United States from 2000 to 2014 was estimated using data from the U.S. Census Bureau and the National Health and Nutrition Examination Survey. Based on obesity trends, we established a time lag between obesity prevalence and NASH‐related waitlist additions. We used data from the U.S. Census Bureau on population projections from 2016 to 2030 to forecast obesity estimates and NASH‐related LT waitlist additions. From 2000 to 2014, the proportion of obese individuals significantly increased 44.9% and the number of NASH‐related annual waitlist additions increased from 391 to 1,605. Increase in obesity prevalence was strongly associated with LT waitlist additions 9 years later in derivation and validation cohorts (R2 = 0.9). Based on these data, annual NASH‐related waitlist additions are anticipated to increase by 55.4% (1,354‐2,104) between 2016 and 2030. There is significant regional variation in obesity rates and in the anticipated increase in NASH‐related waitlist additions (P < 0.01). Conclusion: We project a marked increase in demand for LT for NASH given population obesity trends. Continued public health efforts to curb obesity prevalence are needed to reduce the projected future burden of NASH. (Hepatology 2017).

中文翻译:

美国肥胖和非酒精性脂肪性肝炎相关肝移植候补名单增加的预计增加

非酒精性脂肪性肝炎 (NASH) 肝硬化是美国肝移植 (LT) 增长最快的适应症。我们旨在确定美国 LT 候补名单中肥胖和 NASH 相关新增人数增加背后的时间趋势,并预测 LT 候补名单上未来的 NASH 负担。我们使用 2000 年至 2014 年器官采购和移植网络数据库中的数据来获得 NASH 相关的 LT 候补名单增加的数量。2000 年至 2014 年美国的肥胖人口是使用美国人口普查局和国家健康与营养检查调查的数据估算的。根据肥胖趋势,我们建立了肥胖流行与 NASH 相关候补名单增加之间的时间差。我们使用了美国的数据 人口普查局关于 2016 年至 2030 年人口预测以预测肥胖估计和 NASH 相关 LT 候补名单的增加。从 2000 年到 2014 年,肥胖个体的比例显着增加了 44.9%,与 NASH 相关的年度候补名单增加人数从 391 人增加到 1,605 人。在推导和验证队列中,肥胖患病率的增加与 9 年后 LT 候补名单的增加密切相关(R2 = 0.9)。根据这些数据,预计从 2016 年到 2030 年,每年 NASH 相关候补名单增加人数将增加 55.4%(1,354-2,104)。肥胖率和 NASH 相关候补名单增加的预期增加存在显着区域差异(P 0.01)。结论:鉴于人口肥胖趋势,我们预计 NASH 对 LT 的需求将显着增加。需要持续的公共卫生努力来遏制肥胖流行,以减少 NASH 预计的未来负担。(肝病学 2017)。
更新日期:2018-05-14
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